The Ten Steps to Successful Breastfeeding are a set of practices and policies that constitute an evidence-based quality-improvement initiative to increase breastfeeding rates in healthcare systems. These improvements are known to result in improved infant health and reduced infectious disease rates. The proposed two day conference will bring together a comprehensive, yet targeted, group of health department and state breastfeeding coalition representatives who are currently working toward systematizing implementation of The Ten Steps in their state's maternity facilities. The short-term aims are to define and disseminate "best practices" in systematic implementation of The Ten Steps through collaboration among active states, and to develop a highly specific research agenda for further study of opportunities and challenges to systematized implementation of evidence-based breastfeeding support in America's hospitals. The long term aims are to advance adherence to evidence-based and innovative strategies to increase breastfeeding rates toward the achievement of Healthy People 2020 Objectives, and to encourage and increase the number and quality of studies regarding the effective implementation strategies of The Ten Steps in America's maternity facilities. Relevance: The United States Office of Women's Health Blueprint for Action on Breastfeeding, the CDC Guide to Breastfeeding Interventions, AHRQ's Primary Care Interventions to Promote Breastfeeding, and every other health-related federal institution acknowledge breastfeeding as a public health priority that can be protected and promoted with quality, systematic implementation of The Ten Steps. The proposed effort is in direct response to these calls to action. Results: The conference will result in significant national impact by synergizing and disseminating best practices from seventeen states that have advanced systematic implementation of the Ten Steps. Additional results include the formulation of updated, cost-effective, and feasible implementation strategies and a concurrent, highly-specific research agenda. The outcomes will be broadly disseminated to inform implementation of the Ten Steps for improved quality of practice in hospitals across the US and, accordingly, to increase breastfeeding rates. While participating stakeholders will be primarily public health professionals and community organizers, the outcomes of this conference will be important to consumers, patients, clinicians, institutions, health care system purchasing and infrastructure, policymakers in all sectors, and researchers. The service areas of the collaborators committed to attending correspond to greater than 70% of the live births per year in the United States and represent significant diversity in terms of state-level socioeconomic population variables, breastfeeding rates, average mPINC scores and percent of live births occurring at facilities designated as baby friendly. The products and dissemination resulting from this conference will inform future research, policy, practice, and training of health services researchers. The meeting will also enhance collaborative relationships between AHRQ, state-level stakeholders and national leaders in maternal and child health promotion. PUBLIC HEALTH RELEVANCE: The United States Office of Women's Health Blueprint for Action on Breastfeeding, the CDC Guide to Breastfeeding Interventions, AHRQ's Primary Care Interventions to Promote Breastfeeding and every other health-related federal institution acknowledge breastfeeding as a public health priority that can be protected and promoted with quality, systematic implementation of The Ten Steps. The proposed effort is in direct response to these calls to action.